Changing healthcare providers' behavior during pediatric inductions with an empirically based intervention.
Changing healthcare providers' behavior during pediatric inductions with an empirically based intervention.
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通过基于经验的干预，在小儿归纳期间改变医疗保健提供者的行为。
DOI：
10.1097/aln.0b013e3182207bf5
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发表时间：
2011-07
期刊：
影响因子：
8.8
通讯作者：
Kain ZN
中科院分区：
文献类型：
--
作者：
Martin SR;Chorney JM;Tan ET;Fortier MA;Blount RL;Wald SH;Shapiro NL;Strom SL;Patel S;Kain ZN
每年有400多万儿童经历严重的术前焦虑，这与康复结果不佳有关。医疗保健提供者(HCP)和父母是儿童帮助他们管理术前焦虑的关键资源。本研究报告了一种旨在改变HCP和父母围手术期行为的新干预措施的开发和初步可行性测试，这些行为以前曾被报道与儿童手术前的应对和应激行为有关。开发了一种来自经验的干预措施，即提供者为围手术期压力量身定做的干预措施，以训练HCP增加促进儿童应对的行为，并减少可能加剧儿童痛苦的行为。对干预前后的HCP行为发生率进行编码，并进行比较。此外，对培训前与HCP互动的家长和干预后与HCP互动的家长的行为发生率进行了比较。效果大小表明，接受培训的HC显示出期望行为的比率增加(范围为0.22至1.49)，而不期望行为的比率降低(范围为0.15至2.15)。此外，接受间接培训的父母也显示出他们的期望(范围从0.30到0.60)和不希望的行为(范围从0.16到0.61)的变化。干预成功地改变了HCP和父母的行为。它代表了一种潜在的降低儿童焦虑的临床新方法。最近，美国国家儿童健康与发展研究所资助的一项多点随机对照试验即将启动，该试验将检验这项干预措施在降低儿童术前焦虑和改善儿童术后康复方面的效果。
Each year over 4 million children experience significant levels of preoperative anxiety, which has been linked to poor recovery outcomes. Healthcare providers (HCP) and parents represent key resources for children to help them manage their preoperative anxiety. The present study reports on the development and preliminary feasibility testing of a new intervention designed to change HCP and parent perioperative behaviors that have been previously reported to be associated with children’s coping and stress behaviors before surgery. An empirically-derived intervention, Provider-Tailored Intervention for Perioperative Stress, was developed to train HCPs to increase behaviors that promote children’s coping and decrease behaviors that may exacerbate children’s distress. Rates of HCP behaviors were coded and compared between pre-intervention and post-intervention. Additionally, rates of parents’ behaviors were compared between those that interacted with HCPs before training to those interacting with HCPs post-intervention. Effect sizes indicated that HCPs that underwent training demonstrated increases in rates of desired behaviors (range: 0.22 to 1.49) and decreases in rates of undesired behaviors (range: 0.15 to 2.15). Additionally, parents, who were indirectly trained, also demonstrated changes to their rates of desired (range: 0.30 to 0.60) and undesired behaviors (range: 0.16 to 0.61). The intervention successfully modified HCP and parent behaviors. It represents a potentially new clinical way to decrease anxiety in children. A recently National Institute of Child Health and Development funded multi-site randomized control trial will examine the efficacy of this intervention in reducing children’s preoperative anxiety and improving children’s postoperative recovery is about to start.